Individual provider Active NPI

Julia Shaklee Sammons, M.D.

  • Pediatric Infectious Diseases Physician
  • Philadelphia, PA
National Provider Identifier
1104023167
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD435126 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Phila - Infectious Diseases
Philadelphia, PA 19104-4319
Phone
(215) 590-2017
Fax
(215) 590-2025
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT189071 PA
Pediatric Infectious Diseases Physician 2080P0208X MD435126 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Phila - Infectious Diseases
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ FL 9
Chca Infectious Diseases
Philadelphia, PA 19107-3377
Phone (267) 425-9232

Other names 1

  • Dr. Julia Shaklee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000050 PA Practitioner - Infectious Disease 1355500588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT189071PAMDPediatrics Physician
MD435126PAMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Infectious Diseases CurrentSince Feb 1, 2012 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Feb 1, 2012 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1104023167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ FL 9",
            "address_2": "CHCA INFECTIOUS DISEASES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073377",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILA - INFECTIOUS DISEASES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2017",
            "fax_number": "215-590-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "JULIA",
        "middle_name": "SHAKLEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT189071",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "PA",
            "license": "MD435126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "SHAKLEE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.